We’re glad you’re here and appreciate your interest in Impact Clinical Consulting, LLC.
To request services or begin the new client process, please visit the Appointments tab and submit your request through our scheduling link.
Once your request has been received, you will be sent a welcome email from "SimplePractice" with access to your secure Client Portal. The portal allows you to conveniently complete and submit all required intake paperwork. Please complete the forms using the information of the individual who will be receiving services.
After your completed intake packet has been submitted, our team will reach out to schedule your intake appointment. If you have any questions or experience difficulty accessing the portal, we are happy to assist — please contact us via email.
Required New Client Forms:
New Client Form – Collects demographic information, medical and mental health history, and helps us better understand how we can support you or your family.
Informed Consent Form – Provides permission for Impact Clinical Consulting, LLC to deliver services.
Practice Policies – Shares helpful information regarding appointments, payments, cancellations, and office policies.
Financial Disclosure Agreement – Clarifies financial responsibilities for clients and caregivers.
Notice of Privacy Practices – Explains how protected health information may be used and outlines your rights under HIPAA.
Telehealth Informed Consent Form – Authorizes services provided through a secure video platform.
Credit Card Authorization Form – Allows billing for services rendered.
DASS-21 – Standardized screening tools used to support the clinical assessment process.
Impact Clinical Consulting, LLC offers both in-office and telehealth appointments. For children, we generally recommend in-office sessions whenever possible.
Impact Clinical Consulting, LLC is a self-pay practice. We do not bill private insurance or Medicaid. Payment is due at the time services are provided.
Service Rates:
- Intake Appointment: $175 per client
- Individual Therapy Session: $100 per session
- Conjoint Therapy Session: $150–$175 per session
Additional fees may apply for specialized assessments or services related to family court matters.
